International Consultancy to provide a comprehensive study on school adolescents’ needs, school related factors impacting mental health and wellbeing of adolescents

Contract

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Background

In Uzbekistan, the national authorities appreciate mental health as a new priority in public health, though, there are still clear indicators that mental health is a serious public health problem in the country. Uzbekistan has among the highest mortality rates due to suicides and self-harm among children 10-19 years of Central Asian countries. The suicide mortality rate in 2019 was 9,8 for adolescents aged 10-19 years per 100.000 relevant population. Boys and girls in the age group 15-19 years stand for the highest share of deaths due to suicides and self-harm. Boys in the age-group 15-19 stand for around 74% of all male mortality rate due to suicide and self-harm in the age-group 10-19. Girls in the age group 15-19 stand for around 80% of the female mortality rate due to suicide and self-harm in the age group 10-19. The mortality rate due to suicide and self-harm amongst children under 19 has been increasing consistently from year to year and has almost doubled for boys and tripled for girls since 2008. Never in history has it been higher than now.

The leading five causes that contribute to the disability-adjusted life years (DALYs) lost among adolescents in 2019 present a clear prevalence of mental disorders (depressive and eating disorders) among adolescent girls 10-19 years old and among adolescent boys after unintentional injuries.

Addressing mental health needs in school is critically important as school is where children and adolescents spend a large part of their time—combined with social experiences and challenges, learning demands and mental overload, and psychological stress.

Being able to recognize and support kids’ mental health in schools matters because:

• Mental health problems are common and often develop during childhood and adolescence
• They are treatable!
• Early detection and intervention strategies work. They can help improve resilience and the ability to succeed in school and life.

Therefore, it is important to use school platform to understand the mental health needs of their student population and school related factors that impact the mental health and wellbeing of adolescent boys and girls, since schools related factors, such as socio-emotional and physical safety, connectedness to schools, relationship between teachers and students and among peers, capacity of teachers and learning environment, are the key factors impacting the mental health and wellbeing of adolescent boys and girls. School related factors influence the risk of exposure of adolescents to depressive symptoms, anxiety, violence, and bullying/mobbing, but they also serve as an opportunity to contribute to better mental health development of adolescents. In additions, academic pressure, which is the mental distress with respect to some anticipated frustration associated with academic failure or awareness of the possibility of such failure, is increasingly prevalent. Apart from parental expectations and social norms, the content or organization of learning such as overloaded curriculum, rigid assessment criteria, high stake exams also contribute to the increasing academic pressure of adolescent boys and girls.

In Uzbekistan, the provision of mental health and psycho-social services to students falls within the remit of a few ministries, including the Ministry of Health (MoH) and the Ministry of Public Education (MoPE). To varying degrees, the provision of psycho-social support to adolescents is the responsibility of the Ministry of Interiors (MoI) and the Ministry on Makhalla and Family affairs (MMFA). Each Ministry has a different paradigm of administration, with different areas of responsibility, roles and functions, and has their own programmes and models for dealing with mental health and psychosocial issues. However, there is a need for a multitiered mental health services providing primary, secondary and tertiary interventions for which different sector play different roles in the delivery. Currently, there is a lack of coordination between sectors and tiers in the provision of services as well as quality and gender-responsive services and human resources needed for the care and treatment of psycho-social distress. Stigma around mental health disorders and lack of awareness of mental health and psychosocial related issues as well as limited knowledge of the availability of existing mental health services also hinder practices in seeking for qualified help. In additions, the current service delivery is mainly targeting a limited group of people with severe mental disorders and pays relatively little attention to the provision of services for adolescents’ mental health and for those in psycho-social distress.

Meantime, professional psychological support and counselling for children and adolescents, otherwise regarded as an essential part of the solution to current mental health issues in schools, is scarce or inaccessible. According to the official data, only a half (45%) of school psychologists in schools have bachelor’s degree on psychology, 20% are those who have undergone the trainings on psychology, 34% didn’t receive any kind of specialized training preceding provision of psychological services in schools and are the teachers, remaining 1% are those who graduated specialized colleges/lyceums. In addition, lack of required skills for supporting adolescents with mental health issues impact the ability of psychologists to provide quality counselling.

Moreover, the COVID-19 pandemic – both containment measures and its socio-economic impact - has created uncertainties, stress, and distress. This has impacted the mental health and psychosocial well-being of large numbers of children, adolescents and caregivers, and worsened existing mental health issues, especially for those whose support and/or treatment may have been disrupted as a result of containment measures. In fact, the pandemic also revealed the stark realities of the limitations of current mental health and psycho-social services provision, highlighting significant gaps in systems, services, and the workforce. It also highlighted barriers to accessing available support, including for marginalized and vulnerable groups (including children with disabilities and migrant children) and those living outside urban centres.

To address this, UNICEF Uzbekistan seeks International and National Consultancies to better understand school adolescents’ needs; impact of school related factors on mental health and well-being of adolescent boys and girls; and to map mental health services to adolescents in school in Uzbekistan. It will also explore the role of the education system in reducing stress and anxiety of adolescents and enhancing the social emotional skills they need to succeed in life. The research findings and recommendations will form the basis of future guidelines to strengthen the work of UNICEF Uzbekistan and partners in their mental health programme design, implementation and monitoring and evaluation. The national consultant will work jointly with the Republican Center of Professional Orientation and Psychology-Pedagogical Diagnostics of Students of the Ministry of Public Education, which has technical expertise in the research and analysis of mental health and psychological wellbeing of adolescents to address this complex and multi-layered issue under the context of Uzbekistan.

The study will inform UNICEF, partners and donors about school adolescents’ needs, school related factors impacting mental health and wellbeing of school adolescents and map existing policies and schools’ strategies and actions in recognizing, mitigating and addressing mental health issues of adolescents in and outside school.

Purpose and objectives

The main objective of this consultancy is to provide support to the Ministry of Public Education of Uzbekistan to understand school adolescents’ needs, school related factors impacting mental health and wellbeing of school adolescents and mapping of existing policies and schools’ strategies and actions in recognizing, mitigating and addressing mental health issues of adolescents in and outside school. Based on the evidence, the study will provide age-disaggregated and gender-sensitive recommendations to address mental health and psychosocial needs of younger and older adolescent boys and girls through school platform.

More specifically, the consultancy will need to:

• Provide an overview of available evidence and analysis of i) school adolescents’ mental health needs; ii) school related factors affecting mental health issues of adolescents in Uzbekistan; and iii) taking stock of the key stakeholders, policies, legislations, standards and programme relating to mental health and well-being among adolescents in Uzbekistan.
• Map existing policies and schools’ strategies and actions in recognizing, mitigating and addressing mental health issues of adolescents in and outside school.
• Provide recommendations and action plans on using school platform to provide mental health and psycho-social support and to mitigate and prevent school related mental health risks especially during COVID-19 pandemic. Consider different modalities for reaching younger and older adolescents.

Methodology/Activities

The study will consist of two stages: the first will be a review of secondary materials, the second – entailed primary data collection in a number of sites in Uzbekistan.

Secondary data review. The aim of the reviewing secondary data, including statistical data on school mental health issues, recent researches, documents, legal and policy framework, programmes’ and projects’ evaluations and other relevant sources of information, will be twofold: i) to provide an overall picture of the situation and causes of mental health issues, including suicide, focusing on adolescents in Uzbekistan and ii) to inform the preparation for the primary data collection and analysis, including identifying information gaps.

To complement and triangulate findings from the secondary data review, and to address possible information gaps, primary qualitative and quantitative data collection should be carried out in selected regions of Uzbekistan and an in-depth analysis of key school related risk factors and their impacts on mental health and psychological wellbeing of adolescent boys and girls in Uzbekistan with new qualitative and quantitative evidence undertaken and generated.

Site selection criteria should be decided jointly with the Republican Center of Professional Orientation and Psychology-Pedagogical Diagnostics of Students of the Ministry of Public Education of Uzbekistan and guided by i) the importance of obtaining both an urban and rural perspective, given that there are likely to be differing risk factors in these areas and arguably, as the literature also shows, higher risk factors (e.g. substance abuse, violence) in urban areas; ii) the importance of ensuring that the unique features of different areas are captured; and iii) the need to ensure a selection of areas where a priori there are relatively high levels of mental health issues or risk factors and/or where there are high levels of poverty, which, tends to translate into high levels of stress, anxiety, and other mental health risk factors. Purposive sampling should be used to ensure that the kinds of study respondents required to meet the overall study objectives were included in the sample.

The study will start with the collection of quantitative data, followed by the collection of qualitative data to explain and enrich the quantitative findings. A school-based cross-sectional study should be conducted to investigate school-related factors affecting mental health among adolescents and their correlates in a representative sample of adolescents aged 10-19 years old.

Ethical Considerations

The selected International and National consultants jointly with the Republican Center of Professional Orientation and Psychology-Pedagogical Diagnostics of Students of the Ministry of Public Education of Uzbekistan will identify and specify potential ethical considerations, approaches and review processes in their research methodology and tools, including on harms and benefits, informed consent, privacy and confidentiality, payment and compensation and conflicts of interest. Researchers will have to adhere to the UNICEF Procedure for Ethical Standards in Research, Evaluation, Data Collection and Analysis, requiring contractors to clearly identify any potential ethical issues and approaches, as well as the processes for ethical review and oversight of the research/evaluation/data collection process in their proposal. All researchers engaged in this assignment must complete the UNICEF’s online training module on Ethics.

As outlined in the UNICEF Procedure for Ethical Standards in Research, Evaluation, Data Collection and Analysis and the UNICEF Strategic Guidance Note on Institutionalizing Ethical Practice for UNICEF Research the qualitative part will go through national Ethics Review Board and get approval prior to field work.

Timeline & Deliverables

This consultancy is expected to be carried out within 56 working days for International Consultant and 74 working days for National consultant starting from 1 October 2021 and ending 31 December 2021. Delivery dates (based on the work plan).

The assessment should be designed to ensure participation and inputs from a broad variety of stakeholders (students, parents, psychologists, health care providers, administrators etc.).

I. Inception phase

1. Desk review of secondary data, including statistical data on school mental health issues, including suicides, recent researches, documents, legal and policy framework, programmes’ and projects’ evaluations and other relevant sources of information 2. Develop a conceptual framework, tools for the quantitative study, IDIs, FGDs, KIIs with ethical considerations based on the stakeholders mapping 3. Develop the proposal to External Review Board (ERB) in English and Institutional Review Board (IRB) in Uzbek for ethical review 4. Test, evaluate and adjust tools developed

II. Data collection phase

1. Train researchers to collect qualitative data 2. Conduct surveys, IDIs, FGDs and KIIs in selected regions with stakeholders including teachers, parents, adolescents and government counterparts 3. Provide support to researchers in data collection

III. Data analysis

1. Conduct analysis of the quantitative and qualitative data 2. Consult and reflect feedback/inputs from UNICEF, especially regarding interpretation of data

IV. Finalization phase

1. Develop draft report with recommendations 2. Prepare materials (ppt presentations) and conduct a one-day consultation and feedback meeting with key national stakeholders dealing with the mental health issues to familiarize them with the methodology and findings of the analysis 3. Finalization of report and production an Advocacy brief on the mental health problems of the school’s adolescents in Uzbekistan

Management

It is expected that this work will be conducted by International consultant paired with the national consultant. Both the International and National consultants will work under the direct supervision of UNICEF Health Officer (Adolescents).

Resource requirements:

This assignment will be fully funded through RR. Payment will be done in few installments with no advance payment envisioned.

To qualify as an advocate for every child you will have…

Qualification and Experience

1. Post graduate degree in Psychology, Psychiatry, Social Work, or other relevant discipline(s). Candidates with doctorate level degrees will be an asset.
2. At least ten years of solid professional work experience at the national and international levels with focus on adolescent mental health and psychosocial wellbeing analysis.

Knowledge and Skills

• Demonstrated ability to produce high quality analytical reports.
• Understanding of Uzbekistan context in relation to mental health and/or education is an asset.

Competencies

• Knowledge and experience of UNICEF programmes of cooperation and the human rights-based approach to programming. Prior experience working with UN/UNICEF will be an asset.

Languages

• Excellent writing skills in English language. Knowledge of Russian would be an advantage.

Procedures and Working Conditions

UNICEF undertakes no liability for taxes, duty or other contributions payable by the institutions and/or individuals on payments made under the contract. UNICEF will ensure the detailed briefing of the contracted institution. All necessary documents pertaining to the assignment will be provided.

Reservations:

UNICEF reserves the right to withhold all or a portion of payment if performance is unsatisfactory, if deliverable(s) incomplete, not finalized or for failure to meet deadlines. UNICEF will reserve copyright of all developed materials and own primary data collected through this assignment. The materials cannot be published or disseminated without prior written permission of UNICEF. UNICEF will be free to adapt and modify them in the future. The contractor must respect the confidentiality of the information handled during the assignment. Documents and information provided must be used only for the tasks related to these terms of reference.

UNICEF undertakes no liability for taxes, duty or other contribution payable by the consultant on payments made under this contract.

For every Child, you demonstrate…

UNICEF's values of Care, Respect, Integrity, Trust, and Accountability (CRITA) and core competencies in Communication, Working with People and Drive for Results.

The UNICEF competencies required for this post are...

UNICEF is committed to diversity and inclusion within its workforce, and encourages all candidates, irrespective of gender, nationality, religious and ethnic backgrounds, including persons living with disabilities, to apply to become a part of the organization.

UNICEF has a zero-tolerance policy on conduct that is incompatible with the aims and objectives of the United Nations and UNICEF, including sexual exploitation and abuse, sexual harassment, abuse of authority and discrimination. UNICEF also adheres to strict child safeguarding principles. All selected candidates will be expected to adhere to these standards and principles and will therefore undergo rigorous reference and background checks. Background checks will include the verification of academic credential(s) and employment history. Selected candidates may be required to provide additional information to conduct a background check.

Remarks:

Mobility is a condition of international professional employment with UNICEF and an underlying premise of the international civil service.

Only shortlisted candidates will be contacted and advance to the next stage of the selection process.

Individuals engaged under a consultancy or individual contract will not be considered “staff members” under the Staff Regulations and Rules of the United Nations and UNICEF’s policies and procedures, and will not be entitled to benefits provided therein (such as leave entitlements and medical insurance coverage). Their conditions of service will be governed by their contract and the General Conditions of Contracts for the Services of Consultants and Individual Contractors. Consultants and individual contractors are responsible for determining their tax liabilities and for the payment of any taxes and/or duties, in accordance with local or other applicable laws.